Is cath lab for me?

UM Review RN, ASN, RN · Nov 21, 2006

Hello. I'm a pretty new nurse. Been working in a med-surg floor for about a year and working the floor has brought nothing but stress for me. I hate that I work like a horse almost everyday. I want to be able to do more not just giving meds, waitressing or housekeeping. I looked at the positions open in the hospital and most were for cath lab. Whats the schedule like in cath lab? Is it flex hours too? I dont know ACLS nor telemetry. Do you think they will hire me with very little experience and knowlwedge?

I learned not to say that I was "pretty new" to any geezer old enough to wisecrack, "Yeah, you ARE pretty, even though you're new."

Cath lab is a very intense, fast-paced environment, working very closely with docs. It's clinically fascinating and challenging, but I doubt that you'd have much time to bond with your patients.

I think any area can seem routine after awhile.

I got tired of med-surg. I literally just woke up one day and knew exactly how my day was going to go, exactly what would happen with my patients, and by the time I realized that I knew exactly how each doc would respond to the problems I brought to him/her, I decided that it was time for a change.

I moved to tele and my life hasn't been the same since.

AfloydRN, BSN, RN · Nov 26, 2006

You actually will be working like a horse in the lab if you consider all the lead you will be wearing! You can be taught ACLS, however they will say they prefer someone w/ experience. Get it first, then transfer.

Editorial Team / Admin · Nov 26, 2006

Most labs prefer someone with ICU experience. You'll probably be taking call, which can be brutal at times. Check into the requirements, maybe spend a day or two observing in the cath lab, to see if that kind of nursing might interest you.

It never gets "routine" for me, as each pt is different, each presentation is different, and what we're looking for varies. A diagnostic cath for CAD can turn into an urgent PCI. Pt can go into VT with placement of cath in RCA. Aortic stenosis or mitral stenosis cases require diff't measurements, and skills crossing the stenosed aortic valve. Coronary arteries can have anomalous take-offs, which require skill at 3-D "visualizing" and choosing and directing catheters (mostly on the MD's part, but we give suggestions too). Each pt is different, for us to sedate (or choose not to, depending on mitigating factors). We work as a team (tech, MD, fellow, RN), and I'm forever learning from my colleagues, whether tech, MD, fellow or RN.

We do bond w/our pts, even for the short (1-1 1/2 hr) time they're with us. Many pts have thanked us for using humor to help them relax (using discretion and judgment, as all ppl don't respond positively to it) -- well, yeah, they liked the Versed too.

Check it out, see if it might appeal to you, then set forth to become qualified. Good luck.

Epona · Nov 26, 2006

Someone mentioned wearing lead?? What is that all about? I am interested in Cardiac Nursing.

Thanks! Epona

Indy, LPN, LVN · Dec 3, 2006

Yes, in the cath lab you wear lead aprons, and a lead collar. It's heavy. The patient's on a table with a x-ray type (fluoroscopy?) machine above, which takes real time pictures and displays on a screen for the doc to see. The doc has a tech and a nurse in with him, in our lab. (This is from one day's student observation, I don't work there.)

The tech helps much like a scrub tech would in OR. The nurse monitors the patient and gives meds, does VS, etc. No one in the lab room writes stuff down. They call it out. Someone's outside on a computer with the ability to see the screen that the doc is looking at, and there's an intercom and a glass window. That person is usually an RN and puts all the info being called out, into a computer that timestamps the entries. So at any time you can see at a glance all the VS, and what has been done up to that point. So if the report hasn't been dictated, the floor nurse can still look at the printout and see what has been done to their patient.

I forgot who's the circulating nurse but I know they have one. It might be one of the people outside with the computer. It can get pretty tense in the lab room if the case goes badly or the doc happens to be in a snit.

Epona · Dec 3, 2006

Yikes. Does not sound like that particular job is for me.

THANK YOU for explaining!

cclnurse · Dec 9, 2006

I've worked in CCL for almost 3 years now and I love it. It is not for everyone. It is defiently a select breed. You will work alot at times and there will be some very traumatic times with pt outcomes. I don't know of any RN waling in to a CCL straight from school. Nor do I think that any RN should do that. To really be successful in the cath lab you really need to have a strong cardiac background. You have to be very comfortable with arrythmias and have very good critical thinking skills. I don't want to scare anyone off to the specialty but I take a lot of pride in what we do. There is a lot of 'routine" things that we do everyday. Diagnostic left heart angiograms can get pretty borign sometimes. But then you get into the peripheral aspect of it and that can be interesting. I specialize in Carotid Stenting and it is a real rush. There are so many things that can go wrong in a procedure like that....the pt can stroke, go asystole, or drop their BP very very quickly and you have to be fast in responding. The call and OT is a whole other ballgame. At my facility we take call every 4th weekend and then 2 days a week. Most week nights are fine. You may have the occasional staying late to finish cases, but not too many acutes. It's great though when that pager goes off at 2 am and you know you are going in to save a life!! Words of advice are to definetly do some shadowing for atleast 2 days and see what it's about. Ask lots of questions. The staff will usually be brutally honest about what CCL life is like. Good luck to you!!!

nekhismom · Dec 22, 2006

I've been in the cath lab for almost 2 years now, and before that my only experience was ob and NICU. Talk about a HUGE change and feeling so lost and out of place! I am a fast learner and I ask a ridiculous amount of quesstions, but it was a difficult place to learn. I still learn something new every single day.

In my lab, RN's and all techs do EVERYTHING. Basically, regardless of your background (RN, resp. therapist, rad tech, or scrub tech, whateverr), we all learn to circulate, scrub as a first assistant, and monitor patients. We all administer conscious sedation and any other meds the MD orders. We take turns rotating through all of the positions. It was very difficult for me to learn to scrub at first, but now I love it. My lab is the busiest lab in the state, although we are not the largest lab. We do approximately 7 acute MI's PER WEEK, and several thousand angioplasties per year!! We do approximately 35-50 cases per day in cath, 2-5 in EP (pacers, ablations, etc), and 5-6 in peripheral. We do pacers, ICD's, loop implants and removals in the cath area as well as EP, but we don't do peripherals in the same labs. We take call 7 days every 8 weeks or so, depending on the schedule, and we rotate holiday call. There are very few nights that we don't get called in for an acute, and even fewer days that we don't stay late to finish a case. We are in lead most of the day, and it is HEAVY.

Some days it feels like you are running a marathon with your lead on when you are circulating a PCI of any kind, not just an acute.....running around the lab getting meds, starting o2, starting IV drips, anticoagulating, reassuring the pt, fetching equipment for the md, making sure the scrub person doesn't need any other equipment, watching the pt's vital signs, anticipating needs, etc, all while trying to minimize exposure to x-ray. It is different with every patient, even though the set up generally remains the same.

Scrubbing is fun, too. You still wear the lead, and you are responsibile for maintaining a sterile field at all times, setting up the scrub table and draping the patient in a sterile fashion, and helping the physician with the equipment. For example, when doing angioplasty, I prep balloons and stents and load them over the wire and advance them to the lesion. The MD positions the balloon or stent and then tells me to inflate the balloon or deploy the stent where he has placed it. So, basically, I put stents in patients, while the MD just says where to put it and what pressure to blow the balloon up to and for how long. It's a wonderful feeling.

We do computerized monitoring, and that is like a little break for us. We don't wear lead behind the glass, and we get to sit down for a few minutes. But if the circulator needs help, the monitor person gets up and helps. It's the easiest part of the job physically, but very technical. When doing right heart caths, if your numbers are wrong, you could have a pt. sent for valve surgery when they really don't need it or have pts. who do need surgery not go because your data was inaccurate. You really have to know what you're doing and make sure that you get good data.

I LOVE my job. I love the work that I do, and I LOVE the fact then when I go home every single day, I know that something I have done makes a difference in a patient's life. In exchange for this, I go home nearly every day bone tired, wore out and with a backache from the lead. But it's worth it to me. I can't imagine working anywhere else now that I've gone into the cath lab.

mwall84 · Oct 31, 2011

Question for yall..

I am a paramedic with almost 5 years of experience and hold CPR,ACLS, PALS, ITLS, PITLS, EPC instructor certifications. I love cardiac, and that is what I would consider my forte. I am in the last semester of nursing school. Would the cath lab be a good fit for me most likely?

zcoq72mehs · Nov 1, 2011

Question for yall..
I am a paramedic with almost 5 years of experience and hold CPR,ACLS, PALS, ITLS, PITLS, EPC instructor certifications. I love cardiac, and that is what I would consider my forte. I am in the last semester of nursing school. Would the cath lab be a good fit for me most likely?

I see paramedics doing the ICU and float to ER route, then get their CTRN or CFRN and their FP-C going on to transport/flight nursing.

Either route, I think you'd have a blast in the icu first--it is where i met my first paramedic as a nurse--she had gone thru regents of new york back in 1992 or thereabouts, and went on to get the beforementioned certs and career path i am mentioning.

The cath lab environment can vary considerably from facility to facility, undoubtedly. Some environments I have seen were very uncooperative, and others were very supportive--after all, this is a fast-paced, procedure-type, time-dependent environment, and the new guy can slow things down, so it is preferrable that you have a good starting knowledge base from which to pull (icu)......it also helps to have a good working memory, NO ADD/ADHD, and a higher-than-normal IQ........of course.

I would try the icu first and then do a 'stent' in the cath lab and judge for yourself, with the understanding that some labs are more friendly than others--some have very experienced staff and they are so knowledgeable that it seems 'strange' to them how the new gal just cant get it.

just my 2cents.

CVmursenary · Nov 23, 2011

explain the no add/adhd thing, Maybe your just describing a personality trait but im interested in what you mean?